Presented by Anna Mickell School of Computing and Mathematical Sciences, Auckland University of Technology

1. Community Pharmacy Owners and the NZHIT Plan
Anna Mickell, David Parry, Dong Li and Xu Zhang
School of Computing and Mathematical Science
Auckland University of Technology

2. Lead Researcher/Speaker
 Anna Mickell
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Diploma of Nursing (1985), MBA (2013)
General Manager ProPharma – Present
Business Development MIMS NZ and AU (2002- 05)
Developed NZ’s first consumer health info portal
everybody in early 2000’s
– Nurse in various hospitals, Mt Eden prison and
Cancer Society

3. Background
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Just under 1000 privately owned community pharmacies in NZ
Community pharmacy businesses holds individual DHB contracts (CPSA) for
provision of all community clinical and medicine supply services
Total medicine market size of just under $1 billion at last quarter (IMS Q3
2013)
– Around $800 m from Government revenue
– IT services must provide both inventory and clinical tools to support
government and non government revenue
Service revenue of $380 million (approx)
Massive changes to pharmacy funding occurring
– Capped service funding envelope introduced in 2012
– Declining revenue due to PHARMAC gross and net spend reductions
($50million in last financial year)
– Desperate requirement to improve operating efficiency and/or grow
revenue!

4. Background – Work Stream 3
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NZ HEALTH IT BOARD, NZ IT PLAN 2010
Disclosure: Funding (>$400) for the survey and customer database were provided by ProPharma
NZ HEALTH IT BOARD, NZ IT PLAN 2010 2010

5. Background - Benefits of Work Stream 3
 “benefits of this work steam (3) are that it:
– Reduces adverse drug events
– Improves the use of medicines to treat patients
– Reduces pharmaceutical wastage
– Reduces administrative overheads and manual
handling”
NZ HEALTH IT BOARD, NZ IT PLAN 2010

6. Research Question 1
DO THEY KNOW ABOUT IT?
 What is community pharmacy owner’s awareness of the
aims of the Work Stream 3 of the National IT Health Plan

7. Research Question 2
DO THEY THINK IT WILL WORK?
 To what degree do community pharmacists believe that
successful delivery of 3 key work stream projects are
capable of achieving the stated 4 aims of the work
stream?
– NZULM
– NZ Medicines Formulary
– Community e-prescribing
AIMS
-Reduces adverse drug
events
-Improves the use of
medicines
-Reduces wastage
-Reduces OPEX

8. Method and Response
 Random selection of 120 community pharmacies from a
wholesalers database of 683
 109 community pharmacy shareholders were identified
that had a greater than 10% shareholding in the business
and whose surname was closest to the letter A (where
multiple shareholdings)
 Email invitation sent inviting them to participate in
confidential online survey
 Likert Scale and Yes/No responses only
 59 responded (54%) over a two week period in July 2013

9. Results and Recommendations
 64% of pharmacists don’t know of or are unsure about
the NZHIT Plan
Recommendation:
 The NZHIT Board needs to re-evaluate it’s
communication strategies with regard to the pharmacy
sector
 Amend ‘The Plan’ to include two other “key decision
makers” - community pharmacy owners (and general
practice owners) as those “directly affected” by the plan!

10. Results and Recommendations
 Only 12% of respondents had heard of Patient’s First (Primary Health
Care IT Governance Group)
Recommendation
 Patients First’s poor level of sector awareness suggests that they have
not achieved their core purpose and it’s role, management and/or
memberships should be re-evaluated by the NZHIT Board.
 Leading change requires stakeholders who are knowledgeable, urgent
and powerful .... Memberships are full of “legitimate” office holders ....
“The Board is actively supporting good governance
at all levels and has created a strengthened
implementation leadership and accountability model
for the health sector”.
NZHIT Plan 2010

11. Results and Recommendations
 92% had heard of the NZDF
 12% had heard of the NZULM

12. Results and Recommendations

13. Results

14. Results and Recommendations
 Respondents somewhat more likely to see potential for
OPEX reduction and improving the safe use of medicines
 Overall respondents ambivalent or disbelieving in these
ability of these initiatives to achieve their aims
Recommendation:
 NZHIT Board should focus on OPEX reduction in order to
stimulate demand within the sector.
 NZHIT Board should actively target those in sector who
understand potential and use “jungle drums” to get word
out (proven, effective channels for communicating with
sector)

15. Getting community pharmacy owner’s
attention
 Infrastructure that grows my business!
– Help me attract more patient’s by servicing them faster and better
– Help me looking after the self-care market better (cough, cold,
allergies, weight loss etc)
– Help me be eligible for more Government revenue than others (I’m
in a capped funding environment)
– Help me be the pharmacy of choice in my area for local doctors
and nurses
– Help me, and the funder, measure my effectiveness to prove my
worth

16. Research Question 3
WILL IT IMPROVE MY BUSINESS?
 Do community pharmacists believe that successful
delivery of 3 key work stream projects will improve their
businesses by lifting revenue, maintaining revenue or
mitigating risk?

17. Getting community pharmacy owner’s
attention

18. Getting community pharmacy owner’s
attention

19. Getting community pharmacy owner’s
attention

20. Getting community pharmacy owner’s
attention

21. Getting community pharmacy owner’s
attention

22. Results and Recommendations
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92% of respondents did not know or were unsure how community eprescribing will be funded
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Majority of respondents prefer a funding model that allows them to
determine who they will purchase e-prescribing services from than the
directed approach being rolled out
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98% of respondents did not know what governance structures were in place
to support the roll out of e-prescribing

23. Results and Recommendations
Recommendation:
Research would suggest …
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Directed approach not going to work (is not working)
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NZHIT Board should get out of software ownership/provision and get
into setting standards and offering/suggesting incentives for
performance
NZHIT Board should re-think it’s investment in medicines data and get
clear and urgent on data standards and incentives for performance
NZHIT Board should facilitate informed, “powerful” and “urgent”
community clinicians and service providers to provide the leadership and
governance required to drive the change and lighten up on including
“legitimate” office holders

24. Update 2013/2014

25. Thank you!